Abstract

As the population ages, there is increasing concern about the quality of end-of-life (EOL) care in clinical settings. A number of policy documents (DoH 2000, 2003, 2008) and the national service frameworks for heart disease, cancer and older people have identified end-of-life care as a vital and integral part of patient care. Nurses at all grades, have an important role to play in the delivery of end-of-life care. They are the healthcare providers that are most often with individuals at the end of their lives.

Although the needs of some patients are best met by those with specialist knowledge and qualifications, for the majority of patients this is not necessary. What is required is a palliative and holistic approach to care. Nurses therefore, need to be competent in EOL care and knowledgeable about the palliation of symptoms (Williams and Field 2002).

Pre-registration nursing curriculum has traditionally had a limited emphasis on EOL care (Doyle 1987, Field & Kitson 1986, Dickinson 2007). While there have been significant developments in nurse education and EOL care in the last decade, it is claimed that the amount of EOL content in nurse education remains minimal (Downe-Wambolt and Tamlyn 1997, Ferrell et al 1999, Williams and Field 2002, Walsh and Hogan 2003). Indeed, a number of studies have suggested that current pre-registration nurse education is unlikely to equip students with the skills required to deal adequately with EOL care (White et al 2001, Mallory 2003, Allchin 2006, Dickinson et al 2008). If these reports are accurate, this situation has important implications for the quality of care provided and for the future of nurse education.

Drawing on literature mainly from the UK and USA, this review explores the type and quantity of EOL education within pre-registration nurse education. It considers how this provision is delivered to and perceived by nurses. It reviews the research evidence to determine whether or not newly qualified nurses are adequately prepared to deal with patients at the end of their lives. It will demonstrate that, despite numerous calls in recent years for a greater emphasis on EOL care in nurse training (Allchin 2006), these calls have gone unheeded.